127: Benefit of transoesophageal echocardiography in cardiac surgery: change in diagnosis and surgery planned

Abstract

The value of routine use of transesophageal echocardiography (TOE) in cardiac surgery has been rarely studied in a consecutive series of patients. The aim of this study was to evaluate the contribution of perioperatively TOE in cardiac surgery. This is a prospective study of thirty two consecutive patients undergoing cardiac surgery, in a programmed manner. The data of TOE were compared with preoperative diagnosis retained. In some cases, changing diagnostic led to a modification of the planned intervention. The contributions of TOE were to elucidate of the mechanism of valvular disease, assess its severity, to diagnose morphological, guiding surgery and checking results at the end of the intervention The main types of interventions were: valve replacement or valvuloplasty (51%), CABG (37%), aortic surgery (12%). The diagnosis made preoperatively was modified in 10% of cases (n=21). In 54% of cases, TOE confirmed the diagnosis previously established by transthoracic echocardiography, in 10% of cases the diagnosis made preoperatively was changed, and in 28% of TOE has provided diagnostic and therapeutic solution. The results found for each type of surgical pathology are reported in Table Coronary artery disease Pathology of the mitral valve Pathology of the tricuspid valve Pathology of the aorta Change in diagnosis 3% 20% 11% 16% Change in the intervention planned 1% 13% 9% 16% TOE performed routinely during cardiac surgery may lead to changes in surgery, particularly in the aortic pathology and valvular diseases. In about half of the indications for which review is requested, the supply of TOE is decisive and modifies the treatment instituted. Our study confirms the value of TOE in cardiac surgery, in addition to the indications found in our series of patients, others such as aortic dissection or pulmonary embolism major benefit from the addition of TOE.